Sociodemographic predictors of missed appointments among patients with cleft lip and palate

Jeremy V. Lynn, Kavitha Ranganathan, Matthew H. Bageris, Tami Hart-Johnson, Steven R. Buchman, R. Alexander Blackwood

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To identify disparities in compliance of and care for patients with cleft lip and/or palate (CL/P) by determining the impact of sociodemographic variables on the rate of missed appointments and Child Protective Services (CPS) involvement. Design: A retrospective, noninterventional quality assessment and quality improvement study were designed. Setting: This institutional study was performed at the University of Michigan in Ann Arbor, Michigan. Patients: All patients born between January 1, 2011, and December 31, 2014, who underwent surgical CL/P repair, excluding those with fewer than 5 appointments (n = 178). Main Outcome Measure: The rate of missed appointments, calculated as the total number of no-show appointments divided by the total number of scheduled appointments. All appointments from CL/P diagnosis to data collection were considered, including those outside of plastic surgery. Results: The average patient was 4.5 years of age and had 49 total scheduled appointments. The overall rate of missed appointments was 9.6%, with 66.8% of patients missing at least 1 scheduled visit. Patients who were black (P =.04), not affiliated with a religion (P =.01), Medicaid users (P =.01), from an unstable social background (P =.01), or received need-based financial assistance (P =.00) were significantly more likely to miss appointments. Child Protective Services was involved with 3.9% of patients. Conclusions: Disparities exist in attendance rates among patients with CL/P, and at-risk patient populations have been identified. The allocation of cleft care resources must be efficiently planned in order to enhance the quality of care for at-risk individuals.

Original languageEnglish (US)
Pages (from-to)1440-1446
Number of pages7
JournalCleft Palate-Craniofacial Journal
Volume55
Issue number10
DOIs
StatePublished - Jan 1 2018
Externally publishedYes

Keywords

  • Cleft lip and palate
  • Health disparities
  • Missed appointments

ASJC Scopus subject areas

  • Oral Surgery
  • Otorhinolaryngology

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